Due to the great controversy about the role ojfree radicals in the pathogensis. and the antioxidants in therapy, oj asthma we created this study. The concentrations ojMalondialdehyde (MDA), Vitamins (A and E) in the plasma and BALfiuid were measured in (20) patients with mild episodic asthma (Group I). (20) patients with severe persistent asthma (Group II) and (10) healthy controls (Group Ill). Basline pulmonary Junction and methacholine bronchoprovocation tests (for only Group I & Ill) w ere also performed. Group I & II (asthmatic groups) were given vitamin E (300 IU) and vitamin A (3000 IU) dailyJor one week, then the above parameters were repeated. Asthmatic patients (Group'I &. 11) had signljicant higher levels ojMDA and lower level oj vit A and vit E in both HAL and blood than normal control (P < 0.001). These changes were more statistically evident in Group II than Group I (P < O.OOJ). The Group I and II show a signljicant inverse relation between MDA and vitamins (E & A) levels both in BAL and blood and both beJore and after therapy (r value was greater than -0.4Jor vitamin A and greater than -0.6 Jor vitamin E). Also there was a signljicant direct relation between the levels oj vit A and E and MDA in plasma and their levels in BAL both before and after therapy. Inverse relation between MDA and FEV1, and direct relation between vit E and A levels and FEV1, both in BAL and blood and both beJore and after therapy was detected in both Group I & II. Also, an inverse relation between PD20 and MDA levels in BAL and blood was noted in Group I (r = -0.66 and -0.604 respectively) which means direct relation between lipid peroxidation and airway hyperreactivity. After antioxidant therapy. significant decrease in MDA level (P < 0.001) and increase in vit A and E levels in both blood and BAL (P < 0.001) were noted in both Group 1 and II. Also a significant increase in FEV1. was detected (P < 0.001 Jor group IT and P < 0.05 Jor group 1) and decrease in PD20 in group 1(P < 0.001). These data suggest that bronchial asthma is associated with a higher oxidant load and lower antioxidant deJence which entails the use ojantioxidants as a line ojtherapy in asthmatic patients. |
